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FRENZY ANIMAL RESCUE, INC. 37 ½ W Mill St Po Box 194 New Palestine, In 46163 (317) 414-5662 ADOPTION APPLICATION All lines must be filled out completely or application will not be considered!! Please print legibly. Total process can take up to 2 weeks. There is a $50.00 non refundable deposit to hold an animal until approved. Please tell us about yourself… Name: ______________________________________________________ Home Phone: ___________________ Cell phone:_____________________________ Business Phone: _________________ E-mail Address: Employer: __________________________Phone________________ Spouse/Significant Name: _______________________________________ Number of Children living in the home: _______ Ages: ______________________ Tell us about your home… Address: ______________________________________________ City: __________________State: ___________Zip:_______________ Do you live in a: (house) (apartment) (other) Landlord’s name, & phone number: __________________________________________________________________ Pet you wish to adopt: Dog Bird What are you looking for in an animal?________________________________________________________________________________________________________________________________________________________________________________________________________________________________ What do you expect from an animal ____________________________________________________________________________________________________________________________________________________________Your course of discipline? _)__________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________ Tell us about your “pet history”….________________________________________________________________________________________________________________________________________________________________ Present or past veterinary (Name & phone)________________________________________________________________________________________________________________________________________ Have you ever taken an animal to Animal Control or a Humane Society? If yes, why?________________________________________________________________________________________________________________________________________________________ Please tell us about your new pet’s care….______________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________ Where will the animal be kept during the day? ______________________________ List three references (name address, phone) only one can be a relative _____________________________________________________________________________ ______________________________________________________________________________ ____________________________________________________________________________ There is a non-refundable adoption donation once approved. You must include the $5.00 application donation and if you want a certain dog/bird you must include the $50.00 donation to hold that animal. Signature: _________________________________ Date: ____________________ Spouse signature _________________________ Date _____________________ Please tell us when is the best time for the home visit AM PM
Please copy and paste this into an email to frenzyanimalrescue@sbcglobal.net |
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